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1990年至2021年全球、区域和国家先天性心脏异常负担及2050年预测

Global, regional, and national burdens of congenital heart anomalies from 1990 to 2021, and projections to 2050.

作者信息

Ye Erdengqieqieke, Wu Erman, Tang Tong, La Xiaolin

机构信息

Department of Prenatal Diagnosis, Reproductive Medicine Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.

出版信息

Front Pediatr. 2025 Aug 18;13:1601620. doi: 10.3389/fped.2025.1601620. eCollection 2025.

Abstract

BACKGROUND

Congenital heart anomalies (CHAs) are the most prevalent birth defects, significantly impacting pediatric populations and healthcare systems worldwide. This study provides a comprehensive analysis of the global burden of CHAs, focusing on sex-stratified trends across Socio-Demographic Index (SDI) quintiles from 1990 to 2021.

METHODS

Utilizing data from the Global Burden of Disease (GBD) study, we assessed sex-disaggregated metrics including prevalence, incidence, mortality, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for CHAs in 21 GBD regions and 204 countries.

RESULTS

CHA prevalence and incidence remained stable, with higher incidence in lower SDI regions. Mortality rates, age-standardized DALYs, and YLLs consistently decreased, with males showing higher rates, particularly in low SDI areas. YLDs increased in non-high SDI regions, indicating a growing disability burden. Globally, age-standardized prevalence rates showed a downward trend in countries like China and Ethiopia, while an upward trend was seen in Turkmenistan and Argentina. Incidence rates generally decreased, except in Spain and France. Age-standardized death rates nearly universally declined. YLDs increased in over half of the nations, including Belgium and Spain. Correlation analysis revealed increasing trends of prevalence and YLDs with rising SDI, while incidence, deaths, DALYs, and YLLs demonstrated a declining trend with SDI elevation. From 2022 to 2050, the prevalence of congenital heart anomalies is projected to rise significantly, especially in the 0-4 age group, while mortality rates are expected to continue a slow downward trend, particularly in the 20-69 age group.

CONCLUSIONS

The burden of CHAs is influenced by sex and SDI, with a projected increase in prevalence and a continued decline in mortality. The increasing trend of YLDs highlights the need for targeted public health strategies to address the growing disability burden and ensure global health equity.

摘要

背景

先天性心脏异常(CHAs)是最常见的出生缺陷,对全球儿童群体和医疗保健系统产生重大影响。本研究对CHAs的全球负担进行了全面分析,重点关注1990年至2021年社会人口指数(SDI)五分位数的性别分层趋势。

方法

利用全球疾病负担(GBD)研究的数据,我们评估了21个GBD地区和204个国家中CHAs的性别分类指标,包括患病率、发病率、死亡率、伤残调整生命年(DALYs)、寿命损失年数(YLLs)和残疾生存年数(YLDs)。

结果

CHA的患病率和发病率保持稳定,在较低SDI地区发病率较高。死亡率、年龄标准化DALYs和YLLs持续下降,男性的比率更高,尤其是在低SDI地区。非高SDI地区的YLDs有所增加,表明残疾负担在加重。在全球范围内,中国和埃塞俄比亚等国家的年龄标准化患病率呈下降趋势,而土库曼斯坦和阿根廷则呈上升趋势。发病率总体下降,但西班牙和法国除外。年龄标准化死亡率几乎普遍下降。包括比利时和西班牙在内的一半以上国家的YLDs有所增加。相关分析显示,患病率和YLDs随SDI升高呈上升趋势,而发病率、死亡数、DALYs和YLLs随SDI升高呈下降趋势。从2022年到2050年,预计先天性心脏异常的患病率将显著上升,尤其是在0至4岁年龄组,而死亡率预计将继续缓慢下降趋势,尤其是在20至69岁年龄组。

结论

CHAs的负担受性别和SDI影响,预计患病率会上升,死亡率会持续下降。YLDs的上升趋势凸显了需要有针对性的公共卫生策略来应对日益加重的残疾负担,并确保全球卫生公平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/29eb/12399661/b13a4852f7f4/fped-13-1601620-g001.jpg

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